It is paramount that there is an adequate nursing workforce supply for now and in the future, to achieve equitable and quality health outcomes and consumer access to healthcare, regardless of geographic location. Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses, particularly in the acute care settings in hospitals, jeopardizes the provision of quality health care to consumers. This article provides a literature review of Australian State and Federal Government reports into nurse retention. All reports discuss staff turnover rates; the average age of nurses; enrolment numbers in nursing courses; workloads; nursing workforce shortfalls and the effect on the work environment; leadership and management styles; organizational culture; change management; the mobility of nursing qualifications both locally and internationally and the critical need to value nurses. Then why has the situation of nurse retention not improved? Possible reasons for the continued nurse shortage and the promise of strategic HRM in addressing nurse retention are discussed.
Received 16 October 2006 Accepted 22 February 2007
MRM strategies; nursing management; nurse retention
The focus of this article is the retention of nurses in acute care settings in hospitals in Australia. It is acknowledged that hospitals are operating in a competitive labour market, as nurses are in demand worldwide, therefore retention of experienced nurses is an issue of the highest priority for health service managers.
There are few occupations that have attracted as much interest with regard to supply and demand as professional nursing. There have been regular media reports of nursing shortages and headlines of 'the nursing crisis', as well as a number of State and Federal Government reports into the labour market for nurses (Australian Health Workforce Advisory Committee [AHWAC] 2004; Auditor General, Victoria 2002; Department of Health and Services, Tasmania 2001; NSW Health Department 1998).
This article acknowledges the importance of strategic human resource management (HRM) to the success of retention of nurses in acute care settings in hospitals. HRM performs a strategic function, focusing on the long term, linking business and HRM strategic objectives and forward planning. Kaye (1999) endorses the belief that an organization's effectiveness will be enhanced if human resource considerations are taken into account when selecting business strategy.
Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses jeopardizes many aspects of health care delivery. Therefore nurse employees are valuable assets to health organizations and their services need to be maintained to ensure quality health care is provided to consumers.
This article will discuss issues related to the nursing shortage and provides a literature review of Australian state and territory government reports into the retention of nurses and a strategic HRM approach to the management of nurse employees.
ISSUES RELATED TO THE NURSING SHORTAGE
The shortage of skilled nurses in acute care settings in hospitals is not only an Australia wide problem but a problem globally, as the mobility of nursing qualifications facilitates travel both locally and internationally.
Nursing shortage in the acute inpatient setting
The Queensland Government Ministerial Task-force Report on Nursing Recruitment and Retention (1999: 53) found 'there is a 20.2% turnover of permanent nursing staff in Queensland each year'. 'In Victoria there are 70,000 nurses with 56,000 working in the system and about 2000 dropping out every year' (Witham 2000:9). The Australian Nursing Federation (ANF) Tasmanian delegate conference (2000) highlighted that Tasmania has an additional problem with retention of nurses, as the average age of Tasmania's nurses being older than the rest of Australia, with a very large group due to retire over a 10 year period. …